Dental Therapy: An Alaska Native-Led Solution Improving Access to Care and Oral Health

  ·  Health Policy Hub   ·   Kasey WilsonLaura Hale

Photo Credit: New Mexico Dental Therapist Coalition

November is National Native American Heritage Month

Imagine living in a small, rural town many miles away from the nearest dental clinic. A dentist comes to your community once a year and works feverishly for a week pulling decayed teeth. If you get a bad enough toothache during the other 51 weeks of that year, you have to travel hundreds of miles away to receive treatment. Otherwise, you wait until the dentist comes back next year. For a long time, this was the reality for many Alaska Natives. A reality that is strikingly similar to thousands of people who stand outside of convention centers and sports stadiums or cross the border into Mexico each year to access free or low-cost dental care in hopes of alleviating their agonizing pain.

Fortunately, just over a decade ago, tribal leaders in Alaska decided to look outside the U.S. to find a solution to their oral health crisis. They found dental therapists, additional members of the dental care team who can easily work in traditional office settings, but are specially trained to be first responders working in community-based settings in the highest-need places. And they got it right. Ten years after the first dental therapists began working in Alaska, rates of preventive care use are up and tooth extraction rates are down for both children and adults. Almost all dental therapists working in Alaska Native Tribal communities are Alaska Native themselves, many working with their own people, in their home communities.

This Tribal-led initiative has since made its way well beyond Alaska; dental therapists are now also authorized to practice in Minnesota, Vermont, Maine, Arizona and on Tribal lands in Oregon and Washington state. Many other states are currently actively pursuing or considering legislation to authorize this dental provider. Following the leadership of Tribal governments, state government leaders, policymakers and community members recognized that the access to care issues faced by American Indian and Alaska Native people and the lack of dental providers was not an isolated incident. More than 5,800 places across the country lack enough dental providers to meet community need, and disparities in access to care and oral health outcomes persist.

This month, during Native American Heritage month, we honor the Tribal leaders and community members who were willing to take risks in the face of enormous resistance from the dental establishment and try an innovative solution to meet the needs of their people. The impact of this courage has been a nationwide ripple effect that has positively affected the oral health of not only Alaska Native people who have access to dental therapists, but also many low-income and traditionally underserved individuals in Minnesota and beyond. This movement is only continuing to grow and would not have been possible without the leadership and guidance of Alaska Native Tribal communities.